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            <div class="question-ht" data-iw="4" data-qid="dc2a96c6743d082efad475c477539514" id="id_question">你是男方还是女方？
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                            <div class="ht" id="id_item_title_2aacfbf7aa83fd43328c01d59b52fdce">1994年2月1号之前 </div>
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                            <div class="ht" id="id_item_title_d73aa40933b8f8670ddcfe95fb48b066">1994年2月1号之后 </div>
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                                        <p data-id="726" data-is_parent="9">吉林省</p>
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                                        <p data-id="1972" data-is_parent="14">湖南省</p>
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                                        <p data-id="2112" data-is_parent="21">广东省</p>
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                                        <p data-id="2256" data-is_parent="14">广西壮族自治区</p>
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                                        <p data-id="2380" data-is_parent="20">海南省</p>
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                                        <p data-id="2653" data-is_parent="9">贵州省</p>
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                                        <p data-id="2731" data-is_parent="16">云南省</p>
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                                        <p data-id="2876" data-is_parent="7">西藏自治区</p>
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                                        <p data-id="2886" data-is_parent="10">陕西省</p>
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                                        <p data-id="3004" data-is_parent="14">甘肃省</p>
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                                        <p data-id="3105" data-is_parent="8">青海省</p>
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                                        <p data-id="3153" data-is_parent="5">宁夏回族自治区</p>
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                                        <p data-id="3180" data-is_parent="18">新疆维吾尔自治区</p>
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                                        <p data-id="3237" data-is_parent="23">台湾省</p>
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                                        <p data-id="3261" data-is_parent="18">香港特别行政区</p>
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                                        <p data-id="3281" data-is_parent="31">海外</p>
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                                        <p data-id="3681" data-is_parent="0">居住了一年以上</p>
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                                        <p data-id="3682" data-is_parent="0">居住不到一年的时间</p>
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                                        <p data-id="131" data-is_parent="16">北京市</p>
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                                        <p data-id="157" data-is_parent="16">天津市</p>
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                                        <p data-id="178" data-is_parent="13">河北省</p>
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                                        <p data-id="363" data-is_parent="11">山西省</p>
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                                        <p data-id="494" data-is_parent="12">内蒙古自治区</p>
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                                        <p data-id="611" data-is_parent="14">辽宁省</p>
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                                        <p data-id="726" data-is_parent="9">吉林省</p>
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                                        <p data-id="796" data-is_parent="13">黑龙江省</p>
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                                        <p data-id="935" data-is_parent="18">上海市</p>
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                                        <p data-id="963" data-is_parent="13">江苏省</p>
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                                        <p data-id="1088" data-is_parent="11">浙江省</p>
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                                        <p data-id="1191" data-is_parent="16">安徽省</p>
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                                        <p data-id="1314" data-is_parent="9">福建省</p>
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                                        <p data-id="1409" data-is_parent="11">江西省</p>
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                                        <p data-id="1856" data-is_parent="17">湖北省</p>
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                                        <p data-id="1972" data-is_parent="14">湖南省</p>
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                                        <p data-id="2112" data-is_parent="21">广东省</p>
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                                        <p data-id="3105" data-is_parent="8">青海省</p>
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                                        <p data-id="3153" data-is_parent="5">宁夏回族自治区</p>
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                            <div class="q-tip">失踪两年都找不到人</div>
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                                        <p data-id="4071" data-is_parent="0">1994年2月1号之前（包括2月1号）</p>
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                            <input id="id_input_val_f99c0734e2b90e07dc9ed4139bbeed68" name="input_val_f99c0734e2b90e07dc9ed4139bbeed68"
                                type="hidden" />
                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="131" data-is_parent="16">北京市</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="157" data-is_parent="16">天津市</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="178" data-is_parent="13">河北省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="363" data-is_parent="11">山西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="494" data-is_parent="12">内蒙古自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="611" data-is_parent="14">辽宁省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="726" data-is_parent="9">吉林省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="796" data-is_parent="13">黑龙江省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="935" data-is_parent="18">上海市</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="963" data-is_parent="13">江苏省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1088" data-is_parent="11">浙江省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1191" data-is_parent="16">安徽省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1314" data-is_parent="9">福建省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1409" data-is_parent="11">江西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1520" data-is_parent="17">山东省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1678" data-is_parent="18">河南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1856" data-is_parent="17">湖北省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1972" data-is_parent="14">湖南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2112" data-is_parent="21">广东省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2256" data-is_parent="14">广西壮族自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2380" data-is_parent="20">海南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2406" data-is_parent="38">重庆市</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2449" data-is_parent="21">四川省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2653" data-is_parent="9">贵州省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2731" data-is_parent="16">云南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2876" data-is_parent="7">西藏自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2886" data-is_parent="10">陕西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3004" data-is_parent="14">甘肃省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3105" data-is_parent="8">青海省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3153" data-is_parent="5">宁夏回族自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3180" data-is_parent="18">新疆维吾尔自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3237" data-is_parent="23">台湾省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3261" data-is_parent="18">香港特别行政区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3280" data-is_parent="0">澳门特别行政区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3281" data-is_parent="31">海外</p>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>

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    <div class="mpage">
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            <a href="javascript:void(0)" class="icon-reback" id="id_prev_page">
                <span>上一步</span>
            </a>
            <h1>中国法律服务网</h1>
            <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="5" data-qid="ce3a75f02af5edfb7f1283c9b2747841" id="id_question">债务信息填写？
                <div class="tip">债务：指你们欠别人钱</div>
            </div>
            <div class="weui-wrap">
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_0083cd924c01f0a14207af4e8c52d05b">你们欠了多少钱？（单位：元）
                    </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_0083cd924c01f0a14207af4e8c52d05b" data-it="5"
                            id="id_item_0083cd924c01f0a14207af4e8c52d05b">
                            <div class="weui_cell_hd" id="id_item_state0083cd924c01f0a14207af4e8c52d05b">
                                <tr>
                                    <th></th>
                                    <td>
                                        <input class="weui_input input_val" id="id_input_val_0083cd924c01f0a14207af4e8c52d05b"
                                            name="input_val_0083cd924c01f0a14207af4e8c52d05b" type="number" />
                                    </td>
                                </tr>
                            </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_ed8adb770b3a47f80ef66f56c9b3212b">是在什么时间欠的钱？ </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item c_item" for="id_input_val_ed8adb770b3a47f80ef66f56c9b3212b"
                            data-it="200" id="id_item_ed8adb770b3a47f80ef66f56c9b3212b">
                            <div class="weui_cell_hd" id="id_item_stateed8adb770b3a47f80ef66f56c9b3212b">请选择 </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_02171c4940731dca4663fd0ae9f0dce1">欠的钱是谁去借的？ </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item c_item" for="id_input_val_02171c4940731dca4663fd0ae9f0dce1"
                            data-it="314" id="id_item_02171c4940731dca4663fd0ae9f0dce1">
                            <div class="weui_cell_hd" id="id_item_state02171c4940731dca4663fd0ae9f0dce1">请选择 </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_bd8d67fa75fd5d95f1e676a12233821f">你们有约定谁来还这笔钱吗？
                    </div>
                    <div class="weui_cells_tip">曾经书面约定过或者你们双方协商一致</div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item c_item" for="id_input_val_bd8d67fa75fd5d95f1e676a12233821f"
                            data-it="185" id="id_item_bd8d67fa75fd5d95f1e676a12233821f">
                            <div class="weui_cell_hd" id="id_item_statebd8d67fa75fd5d95f1e676a12233821f">请选择 </div>
                        </label>
                    </div>
                </div>
                <div class="sub_btn">
                    <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_ed8adb770b3a47f80ef66f56c9b3212b">
        <div class="header">
            <a href="javascript:void(0)" class="icon-reback">
                <span>返回</span>
            </a>
        </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="ed8adb770b3a47f80ef66f56c9b3212b"></h2>
                        <div class="widget_select">
                            <input id="id_input_val_ed8adb770b3a47f80ef66f56c9b3212b" name="input_val_ed8adb770b3a47f80ef66f56c9b3212b"
                                type="hidden" />
                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3672" data-is_parent="0">你们领取结婚证以前</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3673" data-is_parent="0">你们领取结婚证以后</p>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_02171c4940731dca4663fd0ae9f0dce1">
        <div class="header">
            <a href="javascript:void(0)" class="icon-reback">
                <span>返回</span>
            </a>
        </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="02171c4940731dca4663fd0ae9f0dce1"></h2>
                        <div class="widget_select">
                            <input id="id_input_val_02171c4940731dca4663fd0ae9f0dce1" name="input_val_02171c4940731dca4663fd0ae9f0dce1"
                                type="hidden" />
                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4379" data-is_parent="0">你去借的</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4380" data-is_parent="0">男方去借的</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4381" data-is_parent="0">你们双方一起去借的</p>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_bd8d67fa75fd5d95f1e676a12233821f">
        <div class="header">
            <a href="javascript:void(0)" class="icon-reback">
                <span>返回</span>
            </a>
        </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="bd8d67fa75fd5d95f1e676a12233821f"> 曾经书面约定过或者你们双方协商一致 </h2>
                        <div class="widget_select">
                            <input id="id_input_val_bd8d67fa75fd5d95f1e676a12233821f" name="input_val_bd8d67fa75fd5d95f1e676a12233821f"
                                type="hidden" />
                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3621" data-is_parent="0">约定你自己偿还</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3622" data-is_parent="0">约定男方自己偿还</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4126" data-is_parent="0">约定双方一起偿还</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4127" data-is_parent="0">没有约定过</p>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>

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            </a>
            <h1>中国法律服务网</h1>
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        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="3" data-qid="157a6ffccf5b4fd5bf917d197d05de0e" id="id_question">其他具体是什么问题？
            </div>
            <div class="weui-wrap">
                <label class="weui_cells weui_cells_input single-input i_item" for="id_input_val_157a6ffccf5b4fd5bf917d197d05de0e"
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                    <div class="weui_cell">
                        <div class="weui_cell_hd" id="id_item_state157a6ffccf5b4fd5bf917d197d05de0e">
                            <tr>
                                <th></th>
                                <td>
                                    <textarea class="weui_input input_val" cols="40" id="id_input_val_157a6ffccf5b4fd5bf917d197d05de0e"
                                        name="input_val_157a6ffccf5b4fd5bf917d197d05de0e" rows="3">
    </textarea>
                                </td>
                            </tr>
                        </div>
                    </div>
                </label>
                <div class="sub_btn">
                    <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a>
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<div class="page">
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        <div class="header">
            <a href="javascript:void(0)" class="icon-reback" id="id_prev_page">
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            <h1>中国法律服务网</h1>
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        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="5" data-qid="826abdef9222eed29f9769701468ebc2" id="id_question">伤者的相关信息填写
            </div>
            <div class="weui-wrap">
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_8686820d4c65462a2fe0300b0fce635d">姓名 </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_8686820d4c65462a2fe0300b0fce635d" data-it="1"
                            id="id_item_8686820d4c65462a2fe0300b0fce635d">
                            <div class="weui_cell_hd" id="id_item_state8686820d4c65462a2fe0300b0fce635d">
                                <tr>
                                    <th></th>
                                    <td>
                                        <input class="weui_input input_val" id="id_input_val_8686820d4c65462a2fe0300b0fce635d"
                                            name="input_val_8686820d4c65462a2fe0300b0fce635d" type="text" />
                                    </td>
                                </tr>
                            </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_ffe474e86a66e79136fc8f2097b70f8e">性别 </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item c_item" for="id_input_val_ffe474e86a66e79136fc8f2097b70f8e"
                            data-it="205" id="id_item_ffe474e86a66e79136fc8f2097b70f8e">
                            <div class="weui_cell_hd" id="id_item_stateffe474e86a66e79136fc8f2097b70f8e">请选择 </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_d8206eca5dd6f265ada9c8dad16df1ae">年龄 </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_d8206eca5dd6f265ada9c8dad16df1ae" data-it="15"
                            id="id_item_d8206eca5dd6f265ada9c8dad16df1ae">
                            <div class="weui_cell_hd" id="id_item_stated8206eca5dd6f265ada9c8dad16df1ae">
                                <tr>
                                    <th></th>
                                    <td>
                                        <input class="weui_input input_val" id="id_input_val_d8206eca5dd6f265ada9c8dad16df1ae"
                                            name="input_val_d8206eca5dd6f265ada9c8dad16df1ae" type="number" />
                                    </td>
                                </tr>
                            </div>
                        </label>
                    </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_f76487cdee2e9f149110da76de67f7d5">户口类型 </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
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                                        <p data-id="4170" data-is_parent="0">城镇户口</p>
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                                        <p data-id="4174" data-is_parent="0">外籍人士</p>
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                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="131" data-is_parent="16">北京市</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="157" data-is_parent="16">天津市</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="178" data-is_parent="13">河北省</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="363" data-is_parent="11">山西省</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="494" data-is_parent="12">内蒙古自治区</p>
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                                        <p data-id="611" data-is_parent="14">辽宁省</p>
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                                        <p data-id="726" data-is_parent="9">吉林省</p>
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                                        <p data-id="796" data-is_parent="13">黑龙江省</p>
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                                        <p data-id="935" data-is_parent="18">上海市</p>
                                    </div>
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                                        <p data-id="963" data-is_parent="13">江苏省</p>
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                                        <p data-id="1088" data-is_parent="11">浙江省</p>
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                                        <p data-id="1191" data-is_parent="16">安徽省</p>
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                                        <p data-id="1314" data-is_parent="9">福建省</p>
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                                        <p data-id="1409" data-is_parent="11">江西省</p>
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                                </div>
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                                        <p data-id="1520" data-is_parent="17">山东省</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1678" data-is_parent="18">河南省</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1856" data-is_parent="17">湖北省</p>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1972" data-is_parent="14">湖南省</p>
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                                        <p data-id="2112" data-is_parent="21">广东省</p>
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                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2256" data-is_parent="14">广西壮族自治区</p>
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                                <div class="weui_cell">
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                                        <p data-id="2380" data-is_parent="20">海南省</p>
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                                        <p data-id="2406" data-is_parent="38">重庆市</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2449" data-is_parent="21">四川省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2653" data-is_parent="9">贵州省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2731" data-is_parent="16">云南省</p>
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                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2876" data-is_parent="7">西藏自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2886" data-is_parent="10">陕西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3004" data-is_parent="14">甘肃省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3105" data-is_parent="8">青海省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3153" data-is_parent="5">宁夏回族自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3180" data-is_parent="18">新疆维吾尔自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3237" data-is_parent="23">台湾省</p>
                                    </div>
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                                <div class="weui_cell">
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                                        <p data-id="3261" data-is_parent="18">香港特别行政区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3280" data-is_parent="0">澳门特别行政区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3281" data-is_parent="31">海外</p>
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    </div>
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                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="131" data-is_parent="16">北京市</p>
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                                        <p data-id="157" data-is_parent="16">天津市</p>
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                                        <p data-id="178" data-is_parent="13">河北省</p>
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                                        <p data-id="363" data-is_parent="11">山西省</p>
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                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="494" data-is_parent="12">内蒙古自治区</p>
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                                </div>
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                                        <p data-id="611" data-is_parent="14">辽宁省</p>
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                                        <p data-id="726" data-is_parent="9">吉林省</p>
                                    </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="796" data-is_parent="13">黑龙江省</p>
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                                        <p data-id="935" data-is_parent="18">上海市</p>
                                    </div>
                                </div>
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                                        <p data-id="963" data-is_parent="13">江苏省</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1088" data-is_parent="11">浙江省</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1191" data-is_parent="16">安徽省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1314" data-is_parent="9">福建省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1409" data-is_parent="11">江西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1520" data-is_parent="17">山东省</p>
                                    </div>
                                </div>
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                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1678" data-is_parent="18">河南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1856" data-is_parent="17">湖北省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="1972" data-is_parent="14">湖南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2112" data-is_parent="21">广东省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2256" data-is_parent="14">广西壮族自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2380" data-is_parent="20">海南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2406" data-is_parent="38">重庆市</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2449" data-is_parent="21">四川省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2653" data-is_parent="9">贵州省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2731" data-is_parent="16">云南省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2876" data-is_parent="7">西藏自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="2886" data-is_parent="10">陕西省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3004" data-is_parent="14">甘肃省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3105" data-is_parent="8">青海省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3153" data-is_parent="5">宁夏回族自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3180" data-is_parent="18">新疆维吾尔自治区</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3237" data-is_parent="23">台湾省</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="3261" data-is_parent="18">香港特别行政区</p>
                                    </div>
                                </div>
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            <div class="question-ht" data-iw="3" data-qid="07ae27d0132999a6a6b3bf62bcd402a3" id="id_question">如果你在系统中没有选到你的伤情或者你的伤情比较特殊，请在下面填写，方便律师提前知晓你的情况；如果没有可不填。
            </div>
            <div class="weui-wrap"><label class="weui_cells weui_cells_input single-input i_item" for="id_input_val_07ae27d0132999a6a6b3bf62bcd402a3"
                    data-it="7" id="id_item_07ae27d0132999a6a6b3bf62bcd402a3">
                    <div class="weui_cell">
                        <div class="weui_cell_hd" id="id_item_state07ae27d0132999a6a6b3bf62bcd402a3">
                            <tr>
                                <th></th>
                                <td><textarea class="weui_input input_val" cols="40" id="id_input_val_07ae27d0132999a6a6b3bf62bcd402a3"
                                        name="input_val_07ae27d0132999a6a6b3bf62bcd402a3" rows="3">
    </textarea></td>
                            </tr>
                        </div>
                    </div>
                </label>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
</div>


<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="2" data-qid="76bc5712056032c60e1bf6d0800793d3" id="id_question"><span
                    class="tips">多选</span>你想咨询什么问题？ </div>
            <div class="weui-wrap">
                <div class="weui_cells weui_cells_radio">
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_ba539ece5abe42b5377feb3a1f252176">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_ba539ece5abe42b5377feb3a1f252176">买房问题 </div>
                            <div id="id_item_stateba539ece5abe42b5377feb3a1f252176"></div>
                            <div class="q-tip">打算买房</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_a2a51c20365012f2eb63edefb9c75363">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_a2a51c20365012f2eb63edefb9c75363">现有财产问题 </div>
                            <div id="id_item_statea2a51c20365012f2eb63edefb9c75363"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_68ecfccbe8396b0bf3a8c82e6033663e">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_68ecfccbe8396b0bf3a8c82e6033663e">彩礼问题 </div>
                            <div id="id_item_state68ecfccbe8396b0bf3a8c82e6033663e"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_25a45119b62d0d22418894c4b9fb8eda">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_25a45119b62d0d22418894c4b9fb8eda">嫁妆问题 </div>
                            <div id="id_item_state25a45119b62d0d22418894c4b9fb8eda"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_9988f00d9a04ba4b49454f3fc1611f82">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_9988f00d9a04ba4b49454f3fc1611f82">小孩问题 </div>
                            <div id="id_item_state9988f00d9a04ba4b49454f3fc1611f82"></div>
                            <div class="q-tip">再婚会不会影响小孩抚养权归属</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_4492f490353d3a4b2505b6873a315deb">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_4492f490353d3a4b2505b6873a315deb">债权债务问题 </div>
                            <div id="id_item_state4492f490353d3a4b2505b6873a315deb"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_accaed4a7d2a2f1378835f0a608de324">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_accaed4a7d2a2f1378835f0a608de324">想写一份婚前财产协议 </div>
                            <div id="id_item_stateaccaed4a7d2a2f1378835f0a608de324"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
</div>

<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="2" data-qid="476ed0800d4d0bae8f51dbe021fba2d9" id="id_question"><span
                    class="tips">多选</span>你有以下哪些财产？ </div>
            <div class="weui-wrap">
                <div class="weui_cells weui_cells_radio">
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_a22950af0087a36d54f3d0b0e66a440d">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_a22950af0087a36d54f3d0b0e66a440d">房子 </div>
                            <div id="id_item_statea22950af0087a36d54f3d0b0e66a440d"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_f6a63ca3374d697cba9ba4653a8688b4">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_f6a63ca3374d697cba9ba4653a8688b4">车子 </div>
                            <div id="id_item_statef6a63ca3374d697cba9ba4653a8688b4"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_ce5fbf423eb5a0149f2ed7c81d48de99">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_ce5fbf423eb5a0149f2ed7c81d48de99">车位 </div>
                            <div id="id_item_statece5fbf423eb5a0149f2ed7c81d48de99"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_6ef733d5f4f4a8dc326144a8d5e5baea">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_6ef733d5f4f4a8dc326144a8d5e5baea">存款 </div>
                            <div id="id_item_state6ef733d5f4f4a8dc326144a8d5e5baea"></div>
                            <div class="q-tip">具体有多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_33cb2de765868bdfb1682af02351e964">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_33cb2de765868bdfb1682af02351e964">股权 </div>
                            <div id="id_item_state33cb2de765868bdfb1682af02351e964"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_6ef733d5f4f4a8dc326144a8d5e5baea">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="6ef733d5f4f4a8dc326144a8d5e5baea"> 具体有多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_6ef733d5f4f4a8dc326144a8d5e5baea"
                                        name="input_val_6ef733d5f4f4a8dc326144a8d5e5baea" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_save6ef733d5f4f4a8dc326144a8d5e5baea"
                        class="weui_btn weui_btn_primary item_input_save">确定</a> </div>
            </div>
        </div>
    </div>
</div>

<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="3" data-qid="22a0045c2975774ffaeae0419c029bb1" id="id_question">具体是什么问题？
            </div>
            <div class="weui-wrap"><label class="weui_cells weui_cells_input single-input i_item" for="id_input_val_22a0045c2975774ffaeae0419c029bb1"
                    data-it="7" id="id_item_22a0045c2975774ffaeae0419c029bb1">
                    <div class="weui_cell">
                        <div class="weui_cell_hd" id="id_item_state22a0045c2975774ffaeae0419c029bb1">
                            <tr>
                                <th></th>
                                <td><textarea class="weui_input input_val" cols="40" id="id_input_val_22a0045c2975774ffaeae0419c029bb1"
                                        name="input_val_22a0045c2975774ffaeae0419c029bb1" rows="3">
    </textarea></td>
                            </tr>
                        </div>
                    </div>
                </label>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
</div>



<div class="page">
    <div class="mpage">
        <div class="header">
            <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>

            <h1>中国法律服务网</h1>

            <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>

        <div class="m-wrap">

            <div class="question-ht" data-iw="3" data-qid="2a181fe835d1a3df5f3a89f09e16210b" id="id_question">女方是什么时候知道的？


                <div class="tip">你隐藏、转移、变卖、毁坏夫妻共同财产、伪造债务的？</div>

            </div>


            <div class="weui-wrap">

                <label class="weui_cells weui_cells_input single-input i_item" for="id_input_val_2a181fe835d1a3df5f3a89f09e16210b"
                    data-it="3" id="id_item_2a181fe835d1a3df5f3a89f09e16210b">
                    <div class="weui_cell">
                        <div class="weui_cell_hd" id="id_item_state2a181fe835d1a3df5f3a89f09e16210b">

                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_2a181fe835d1a3df5f3a89f09e16210b"
                                        name="input_val_2a181fe835d1a3df5f3a89f09e16210b" type="date" /></td>
                            </tr>

                        </div>
                    </div>
                </label>
                <div class="sub_btn">
                    <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a>
                </div>


            </div>
        </div>
    </div>


</div>

<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="2" data-qid="a345f35e3e810f5d5c99a4d0de7e966a" id="id_question"><span
                    class="tips">多选</span>隐藏了以下什么财产？ </div>
            <div class="weui-wrap">
                <div class="weui_cells weui_cells_radio">
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_c834b5bc15f673b4cdd7ebf4131c9f7d">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_c834b5bc15f673b4cdd7ebf4131c9f7d">房子
                            </div>
                            <div id="id_item_statec834b5bc15f673b4cdd7ebf4131c9f7d"></div>
                            <div class="q-tip">房子现在值多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_ff3235ddc5ba2ee4f57a1c2844d39d1a">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_ff3235ddc5ba2ee4f57a1c2844d39d1a">车子
                            </div>
                            <div id="id_item_stateff3235ddc5ba2ee4f57a1c2844d39d1a"></div>
                            <div class="q-tip">车子现在值多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_5e41f701366cd470d887e490a0a0a47c">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_5e41f701366cd470d887e490a0a0a47c">存款
                            </div>
                            <div id="id_item_state5e41f701366cd470d887e490a0a0a47c"></div>
                            <div class="q-tip">该笔存款具体有多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_c473a7ba4253512b50439135b72dbbc4">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_c473a7ba4253512b50439135b72dbbc4">合伙企业、公司股权
                            </div>
                            <div id="id_item_statec473a7ba4253512b50439135b72dbbc4"></div>
                            <div class="q-tip">该股权现在值多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_eedb0a6c2b10db60a7df6e1f6b49930c">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_eedb0a6c2b10db60a7df6e1f6b49930c">养老保险金、公积金
                            </div>
                            <div id="id_item_stateeedb0a6c2b10db60a7df6e1f6b49930c"></div>
                            <div class="q-tip">账户上具体有多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="5" id="id_item_71ab30f0a2eb91904c4630721b4d2609">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_71ab30f0a2eb91904c4630721b4d2609">字画、书稿
                            </div>
                            <div id="id_item_state71ab30f0a2eb91904c4630721b4d2609"></div>
                            <div class="q-tip">估一下值多少钱？</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_8e77b7b201d73efe57934b007c0c46f5">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_8e77b7b201d73efe57934b007c0c46f5">其他财产
                            </div>
                            <div id="id_item_state8e77b7b201d73efe57934b007c0c46f5"></div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_c834b5bc15f673b4cdd7ebf4131c9f7d">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="c834b5bc15f673b4cdd7ebf4131c9f7d">
                            房子现在值多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_c834b5bc15f673b4cdd7ebf4131c9f7d"
                                        name="input_val_c834b5bc15f673b4cdd7ebf4131c9f7d" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_savec834b5bc15f673b4cdd7ebf4131c9f7d"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_ff3235ddc5ba2ee4f57a1c2844d39d1a">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="ff3235ddc5ba2ee4f57a1c2844d39d1a">
                            车子现在值多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_ff3235ddc5ba2ee4f57a1c2844d39d1a"
                                        name="input_val_ff3235ddc5ba2ee4f57a1c2844d39d1a" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_saveff3235ddc5ba2ee4f57a1c2844d39d1a"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_5e41f701366cd470d887e490a0a0a47c">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="5e41f701366cd470d887e490a0a0a47c">
                            该笔存款具体有多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_5e41f701366cd470d887e490a0a0a47c"
                                        name="input_val_5e41f701366cd470d887e490a0a0a47c" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_save5e41f701366cd470d887e490a0a0a47c"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_c473a7ba4253512b50439135b72dbbc4">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="c473a7ba4253512b50439135b72dbbc4">
                            该股权现在值多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_c473a7ba4253512b50439135b72dbbc4"
                                        name="input_val_c473a7ba4253512b50439135b72dbbc4" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_savec473a7ba4253512b50439135b72dbbc4"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_eedb0a6c2b10db60a7df6e1f6b49930c">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="eedb0a6c2b10db60a7df6e1f6b49930c">
                            账户上具体有多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_eedb0a6c2b10db60a7df6e1f6b49930c"
                                        name="input_val_eedb0a6c2b10db60a7df6e1f6b49930c" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_saveeedb0a6c2b10db60a7df6e1f6b49930c"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_71ab30f0a2eb91904c4630721b4d2609">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="71ab30f0a2eb91904c4630721b4d2609">
                            估一下值多少钱？ </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_71ab30f0a2eb91904c4630721b4d2609"
                                        name="input_val_71ab30f0a2eb91904c4630721b4d2609" type="number" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_save71ab30f0a2eb91904c4630721b4d2609"
                        class="weui_btn weui_btn_primary item_input_save">确定</a>
                </div>
            </div>
        </div>
    </div>
</div>

<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="1" data-qid="d7e42e6f07d51f5d294d0cd64b9c9589" id="id_question">你现在是否属于离职状态？
            </div>
            <div class="weui-wrap">
                <div class="weui_cells weui_cells_radio">
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_a5b209cd825812293a6edb63306f0369">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_a5b209cd825812293a6edb63306f0369">还在职 </div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="3" id="id_item_af685fe2f4f922504a3589bac8e60449">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_af685fe2f4f922504a3589bac8e60449">已经离职 </div>
                            <div class="q-tip">请填写具体的离职时间</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_af685fe2f4f922504a3589bac8e60449">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="af685fe2f4f922504a3589bac8e60449"> 请填写具体的离职时间 </h2>
                        <div class="bd">
                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_af685fe2f4f922504a3589bac8e60449"
                                        name="input_val_af685fe2f4f922504a3589bac8e60449" type="date" /></td>
                            </tr>
                        </div>
                    </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_item_saveaf685fe2f4f922504a3589bac8e60449"
                        class="weui_btn weui_btn_primary item_input_save">确定</a> </div>
            </div>
        </div>
    </div>
</div>

<div class="testWrap">
    <div class="q_box">
        <div class="item">
            <h3 class="ht" class="question-ht" data-iw="2" data-qid="9fb71af39074e1b260cbecb65b81fe46" id="id_question"><strong>(多选)</strong>关于工资你想咨询什么问题
            </h3>
            <div class="item-options">
                <div class="options-checkbox">
                    <div class="container-fluid">
                        <div class="row clearfix ">
                            <div class="options_row c_item" data-it="0" id="id_item_ecacee8963c8f5aa202c2b9bb45e1afb">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_ecacee8963c8f5aa202c2b9bb45e1afb">单位不发（拖欠）工资
                                    </span>
                                    <div id="id_item_stateecacee8963c8f5aa202c2b9bb45e1afb" class="option-data"></div>
                                </div>
                            </div>
                            <div class="options_row c_item" data-it="0" id="id_item_7c789780eef2b58343d239b7d3d08c1a">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_7c789780eef2b58343d239b7d3d08c1a">单位少发（克扣）工资
                                    </span>
                                    <div id="id_item_state7c789780eef2b58343d239b7d3d08c1a" class="option-data"></div>
                                </div>
                            </div>
                            <div class="options_row c_item" data-it="0" id="id_item_16a4a4a9b4311164bd3d325d55e3260f">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_16a4a4a9b4311164bd3d325d55e3260f">自动离职，单位不发工资</span>
                                    <div id="id_item_state16a4a4a9b4311164bd3d325d55e3260f" class="option-data"></div>
                                </div>
                            </div>
                            <div class="options_row c_item" data-it="0" id="id_item_2191c848045dbb38bad5b6b5009f4334">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_2191c848045dbb38bad5b6b5009f4334">劳动合同中没有对工资进行明确约定</span>
                                    <div id="id_item_state2191c848045dbb38bad5b6b5009f4334" class="option-data"></div>
                                </div>
                            </div>
                            <div class="options_row c_item" data-it="1" id="id_item_4ae9cf62b1d4d102c0f4d7e1f7e38afd">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_4ae9cf62b1d4d102c0f4d7e1f7e38afd">其他
                                        <b>(选择后请输入具体问题，也可以直接留下联系方式)</b> </span>
                                    <div id="id_item_state4ae9cf62b1d4d102c0f4d7e1f7e38afd" class="option-data"></div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="sub_btn"> <a href="javascript:;" class="t-btn next" id="id_post_btn">确定</a> </div> <a href="javascript:;"
        id="id_prev_page" class="prev" data-toggle="tooltip" data-placement="top" title="返回上一题"><i class="glyphicon glyphicon-chevron-left"></i></a>
    <div class="reset">需要重新填写你的情况，请点击<a href="javascript:void(0)" id="id_restart">重填</a></div>
</div>
<div class="modal fade widget_modal" id="id_item_slider_4ae9cf62b1d4d102c0f4d7e1f7e38afd" tabindex="-1" role="dialog">
    <div class="modal-dialog modal-sm">
        <div class="modal-content">
            <div class="modal-header">
                <div class="ht" data-iw="0" data-qid="4ae9cf62b1d4d102c0f4d7e1f7e38afd">其他</div>
                <div class="tip">选择后请输入具体问题，也可以直接留下联系方式</div>
            </div>
            <div class="modal-body">
                <div class="content">
                    <div class="options-input item_form_4ae9cf62b1d4d102c0f4d7e1f7e38afd">
                        <tr>
                            <th></th>
                            <td><input class="input_text" id="id_input_val_4ae9cf62b1d4d102c0f4d7e1f7e38afd" name="input_val_4ae9cf62b1d4d102c0f4d7e1f7e38afd"
                                    type="text" /></td>
                        </tr>
                        <div class="errtip">＊请填写信息，不能为空</div>
                    </div>
                </div>
            </div>
            <div class="modal-footer"> <button type="button" class="item_input_save btn btn-orange" id="id_item_save4ae9cf62b1d4d102c0f4d7e1f7e38afd">确定</button>
                <button type="button" class="btn btn-gray" data-dismiss="modal" aria-label="Close">取消</button> </div>
        </div>
    </div>
</div>


<div class="page">
    <div class="mpage">
        <div class="header">
            <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>

            <h1>中国法律服务网</h1>

            <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>

        <div class="m-wrap">

            <div class="question-ht" data-iw="3" data-qid="6b5cb58e8f893721181cf3ebd1fe560f" id="id_question">单位不发（拖欠）工资长达几个月了？


                <div class="tip">请填写具体数字，如：1个月填写数值“1“，不满1个月也按照1个月来填</div>

            </div>


            <div class="weui-wrap">

                <label class="weui_cells weui_cells_input single-input i_item" for="id_input_val_6b5cb58e8f893721181cf3ebd1fe560f"
                    data-it="4" id="id_item_6b5cb58e8f893721181cf3ebd1fe560f">
                    <div class="weui_cell">
                        <div class="weui_cell_hd" id="id_item_state6b5cb58e8f893721181cf3ebd1fe560f">

                            <tr>
                                <th></th>
                                <td><input class="weui_input input_val" id="id_input_val_6b5cb58e8f893721181cf3ebd1fe560f"
                                        name="input_val_6b5cb58e8f893721181cf3ebd1fe560f" type="number" /></td>
                            </tr>

                        </div>
                    </div>
                </label>
                <div class="sub_btn">
                    <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a>
                </div>


            </div>

        </div>
    </div>


</div>



<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="1" data-qid="eb25612e30b48549e265e0c37602489a" id="id_question">你们有没有领结婚证？
            </div>
            <div class="weui-wrap">
                <div class="weui_cells weui_cells_radio">
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="0" id="id_item_734e4e8df5c1cf2ed8c3157e1be7f38c">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_734e4e8df5c1cf2ed8c3157e1be7f38c">有结婚证 </div>
                            <div class="q-tip"></div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                    <div class="weui_cell weui_checked lp_radio c_item" data-it="282" id="id_item_4b4eedaa46be236eca68681ae8d172b2">
                        <div class="weui_cell_bd weui_cell_primary">
                            <div class="ht" id="id_item_title_4b4eedaa46be236eca68681ae8d172b2">没有结婚证 </div>
                            <div class="q-tip">你们是什么时候开始同居的</div>
                        </div>
                        <div class="weui_cell_hd"> <span class="weui_icon_checked"></span> </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="page-silder" id="id_item_slider_4b4eedaa46be236eca68681ae8d172b2">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback"> <span>返回</span> </a> </div>
        <div class="m-wrap">
            <div class="weui_cells weui_cells_form widget_box">
                <div class="weui_cell">
                    <div class="weui_cell_bd weui_cell_primary">
                        <h2 class="ht" data-iw="0" data-qid="4b4eedaa46be236eca68681ae8d172b2"> 你们是什么时候开始同居的 </h2>
                        <div class="widget_select"> <input id="id_input_val_4b4eedaa46be236eca68681ae8d172b2" name="input_val_4b4eedaa46be236eca68681ae8d172b2"
                                type="hidden" />
                            <div class="widget_items">
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4071" data-is_parent="0">1994年2月1号之前（包括2月1号）</p>
                                    </div>
                                </div>
                                <div class="weui_cell">
                                    <div class="weui_cell_bd weui_cell_primary">
                                        <p data-id="4072" data-is_parent="0">1994年2月1号之后</p>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>


<div class="page">
    <div class="mpage">
        <div class="header"> <a href="javascript:void(0)" class="icon-reback" id="id_prev_page"><span>上一步</span></a>
            <h1>中国法律服务网</h1> <a href="javascript:void(0)" class="rt" id="id_restart">重填</a>
        </div>
        <div class="m-wrap">
            <div class="question-ht" data-iw="5" data-qid="3a6116848008f97102200261a4954aa5" id="id_question">复员军人信息填写
            </div>
            <div class="weui-wrap">
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_8bed2f30c663e55b8f017ecc8a1d10ef">复员军人有多少复员费？（单位：元）
                        <span class="tips">选填</span></div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_8bed2f30c663e55b8f017ecc8a1d10ef" data-it="5"
                            id="id_item_8bed2f30c663e55b8f017ecc8a1d10ef">
                            <div class="weui_cell_hd" id="id_item_state8bed2f30c663e55b8f017ecc8a1d10ef">
                                <tr>
                                    <th></th>
                                    <td><input class="weui_input input_val" id="id_input_val_8bed2f30c663e55b8f017ecc8a1d10ef"
                                            name="input_val_8bed2f30c663e55b8f017ecc8a1d10ef" type="number" /></td>
                                </tr>
                            </div>
                        </label> </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_44b8a746635877ddfbee73184075434b">复员军人有多少自主择业费？（单位：元）
                        <span class="tips">选填</span></div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_44b8a746635877ddfbee73184075434b" data-it="5"
                            id="id_item_44b8a746635877ddfbee73184075434b">
                            <div class="weui_cell_hd" id="id_item_state44b8a746635877ddfbee73184075434b">
                                <tr>
                                    <th></th>
                                    <td><input class="weui_input input_val" id="id_input_val_44b8a746635877ddfbee73184075434b"
                                            name="input_val_44b8a746635877ddfbee73184075434b" type="number" /></td>
                                </tr>
                            </div>
                        </label> </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_a5c4d18f5b191157bc4ec8c0d841d09d">复员军人入伍时实际年龄为多少岁？
                    </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input">
                        <label class="weui_cell i_item" for="id_input_val_a5c4d18f5b191157bc4ec8c0d841d09d" data-it="4"
                            id="id_item_a5c4d18f5b191157bc4ec8c0d841d09d">
                            <div class="weui_cell_hd" id="id_item_statea5c4d18f5b191157bc4ec8c0d841d09d">
                                <tr>
                                    <th></th>
                                    <td><input class="weui_input input_val" id="id_input_val_a5c4d18f5b191157bc4ec8c0d841d09d"
                                            name="input_val_a5c4d18f5b191157bc4ec8c0d841d09d" type="number" /></td>
                                </tr>
                            </div>
                        </label> </div>
                </div>
                <div class="questoin_more_options lp_input">
                    <div class="weui_cells_title" id="id_item_title_7d568f6b678c579c7abdd5971e9ce6b3">你们的结婚日期是？
                    </div>
                    <div class="weui_cells_tip"></div>
                    <div class="weui_cells weui_cells_input"> <label class="weui_cell i_item" for="id_input_val_7d568f6b678c579c7abdd5971e9ce6b3"
                            data-it="3" id="id_item_7d568f6b678c579c7abdd5971e9ce6b3">
                            <div class="weui_cell_hd" id="id_item_state7d568f6b678c579c7abdd5971e9ce6b3">
                                <tr>
                                    <th></th>
                                    <td><input class="weui_input input_val" id="id_input_val_7d568f6b678c579c7abdd5971e9ce6b3"
                                            name="input_val_7d568f6b678c579c7abdd5971e9ce6b3" type="date" /></td>
                                </tr>
                            </div>
                        </label> </div>
                </div>
                <div class="sub_btn"> <a href="javascript:void(0)" id="id_post_btn" class="weui_btn weui_btn_primary">确定</a></div>
            </div>
        </div>
    </div>
</div>

<div class="testWrap">
    <div class="q_box">
        <div class="item">
            <h3 class="ht" class="question-ht" data-iw="1" data-qid="5457bb04055b75b8f6c934eb37a8e979" id="id_question">你属于下列哪种情形？</h3>
            <div class="item-options">
                <div class="options-radio">
                    <div class="container-fluid">
                        <div class="row clearfix ">
                            <div class="options_row c_item" data-it="0" id="id_item_631b3057473e643db6bcb304b8c9b89a">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_631b3057473e643db6bcb304b8c9b89a">自然人
                                        <b>(个人)</b></span> </div>
                            </div>
                            <div class="options_row c_item" data-it="0" id="id_item_5bdd7ef45d21eb3340733592b76a9a9e">
                                <div class="option-wrap"> <span class="option-ht" id="id_item_title_5bdd7ef45d21eb3340733592b76a9a9e">法人
                                        <b>(公司、企业)</b></span> </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div> <a href="javascript:;" id="id_prev_page" class="prev" data-toggle="tooltip" data-placement="top" title="返回上一题"><i
            class="glyphicon glyphicon-chevron-left"></i></a>
    <div class="reset">需要重新填写你的情况，请点击<a href="javascript:void(0)" id="id_restart">重填</a></div>
</div>

<div class="testWrap">
    <div class="q_box">
        <div class="item">
            <h3 class="ht" class="question-ht" data-iw="5" data-qid="1465176bd006cb0a8ed35465552fd80a" id="id_question">你的基本信息填写</h3>
            <div class="pt">所填信息须与身份证上的一致</div>
            <div class="item-options">
                <div class="options-input-row2">
                    <div class="container-fluid">
                        <div class="row clearfix">
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_759b615f767e4e77383a1138b51c0f3f"><strong>选填</strong>姓名</div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_759b615f767e4e77383a1138b51c0f3f"
                                        data-it="1" id="id_item_759b615f767e4e77383a1138b51c0f3f">
                                        <div class="inputs item_form_759b615f767e4e77383a1138b51c0f3f" id="id_item_state759b615f767e4e77383a1138b51c0f3f">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_759b615f767e4e77383a1138b51c0f3f"
                                                        name="input_val_759b615f767e4e77383a1138b51c0f3f" type="text" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_2faac9d57018a6e790b1e645d6644380"><strong>选填</strong>性别</div>
                                <div class="inputs"> <label class="i_item c_item" for="id_input_val_2faac9d57018a6e790b1e645d6644380"
                                        data-it="257" id="id_item_2faac9d57018a6e790b1e645d6644380"> <input id="id_input_val_2faac9d57018a6e790b1e645d6644380"
                                            name="input_val_2faac9d57018a6e790b1e645d6644380" type="hidden" />
                                        <div id="id_item_state2faac9d57018a6e790b1e645d6644380" class="input_text"></div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_840d01633fe8d02fbe09097db2c6aa0c"><strong>选填</strong>民族</div>
                                <div class="inputs"> <label class="i_item c_item" for="id_input_val_840d01633fe8d02fbe09097db2c6aa0c"
                                        data-it="258" id="id_item_840d01633fe8d02fbe09097db2c6aa0c"> <input id="id_input_val_840d01633fe8d02fbe09097db2c6aa0c"
                                            name="input_val_840d01633fe8d02fbe09097db2c6aa0c" type="hidden" />
                                        <div id="id_item_state840d01633fe8d02fbe09097db2c6aa0c" class="input_text"></div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_c8c85376d4dd8c5d49ebf51b7e56128d"><strong>选填</strong>籍贯</div>
                                <div class="inputs"> <label class="i_item c_item" for="id_input_val_c8c85376d4dd8c5d49ebf51b7e56128d"
                                        data-it="103" id="id_item_c8c85376d4dd8c5d49ebf51b7e56128d"> <input id="id_input_val_c8c85376d4dd8c5d49ebf51b7e56128d"
                                            name="input_val_c8c85376d4dd8c5d49ebf51b7e56128d" type="hidden" />
                                        <div id="id_item_statec8c85376d4dd8c5d49ebf51b7e56128d" class="input_text"></div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_fbecf4d4d52249a49c68da5f42f5ef53"><strong>选填</strong>出生日期</div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_fbecf4d4d52249a49c68da5f42f5ef53"
                                        data-it="3" id="id_item_fbecf4d4d52249a49c68da5f42f5ef53">
                                        <div class="inputs item_form_fbecf4d4d52249a49c68da5f42f5ef53 date-select" id="id_item_statefbecf4d4d52249a49c68da5f42f5ef53">
                                            <tr>
                                                <th></th>
                                                <td><select class="date_input year_input" id="id_input_val_fbecf4d4d52249a49c68da5f42f5ef53_0"
                                                        name="input_val_fbecf4d4d52249a49c68da5f42f5ef53_0">
                                                        <option value="2018" selected="selected">2018</option>
                                                        <option value="2017">2017</option>
                                                        <option value="2016">2016</option>
                                                        <option value="2015">2015</option>
                                                        <option value="2014">2014</option>
                                                        <option value="2013">2013</option>
                                                        <option value="2012">2012</option>
                                                        <option value="2011">2011</option>
                                                        <option value="2010">2010</option>
                                                        <option value="2009">2009</option>
                                                        <option value="2008">2008</option>
                                                        <option value="2007">2007</option>
                                                        <option value="2006">2006</option>
                                                        <option value="2005">2005</option>
                                                        <option value="2004">2004</option>
                                                        <option value="2003">2003</option>
                                                        <option value="2002">2002</option>
                                                        <option value="2001">2001</option>
                                                        <option value="2000">2000</option>
                                                        <option value="1999">1999</option>
                                                        <option value="1998">1998</option>
                                                        <option value="1997">1997</option>
                                                        <option value="1996">1996</option>
                                                        <option value="1995">1995</option>
                                                        <option value="1994">1994</option>
                                                        <option value="1993">1993</option>
                                                        <option value="1992">1992</option>
                                                        <option value="1991">1991</option>
                                                        <option value="1990">1990</option>
                                                        <option value="1989">1989</option>
                                                        <option value="1988">1988</option>
                                                        <option value="1987">1987</option>
                                                        <option value="1986">1986</option>
                                                        <option value="1985">1985</option>
                                                        <option value="1984">1984</option>
                                                        <option value="1983">1983</option>
                                                        <option value="1982">1982</option>
                                                        <option value="1981">1981</option>
                                                        <option value="1980">1980</option>
                                                        <option value="1979">1979</option>
                                                        <option value="1978">1978</option>
                                                        <option value="1977">1977</option>
                                                        <option value="1976">1976</option>
                                                        <option value="1975">1975</option>
                                                        <option value="1974">1974</option>
                                                        <option value="1973">1973</option>
                                                        <option value="1972">1972</option>
                                                        <option value="1971">1971</option>
                                                        <option value="1970">1970</option>
                                                        <option value="1969">1969</option>
                                                        <option value="1968">1968</option>
                                                        <option value="1967">1967</option>
                                                        <option value="1966">1966</option>
                                                        <option value="1965">1965</option>
                                                        <option value="1964">1964</option>
                                                        <option value="1963">1963</option>
                                                        <option value="1962">1962</option>
                                                        <option value="1961">1961</option>
                                                        <option value="1960">1960</option>
                                                        <option value="1959">1959</option>
                                                        <option value="1958">1958</option>
                                                        <option value="1957">1957</option>
                                                        <option value="1956">1956</option>
                                                        <option value="1955">1955</option>
                                                        <option value="1954">1954</option>
                                                        <option value="1953">1953</option>
                                                        <option value="1952">1952</option>
                                                        <option value="1951">1951</option>
                                                        <option value="1950">1950</option>
                                                        <option value="1949">1949</option>
                                                        <option value="1948">1948</option>
                                                        <option value="1947">1947</option>
                                                        <option value="1946">1946</option>
                                                        <option value="1945">1945</option>
                                                        <option value="1944">1944</option>
                                                        <option value="1943">1943</option>
                                                        <option value="1942">1942</option>
                                                        <option value="1941">1941</option>
                                                        <option value="1940">1940</option>
                                                        <option value="1939">1939</option>
                                                        <option value="1938">1938</option>
                                                        <option value="1937">1937</option>
                                                        <option value="1936">1936</option>
                                                        <option value="1935">1935</option>
                                                        <option value="1934">1934</option>
                                                        <option value="1933">1933</option>
                                                        <option value="1932">1932</option>
                                                        <option value="1931">1931</option>
                                                        <option value="1930">1930</option>
                                                        <option value="1929">1929</option>
                                                        <option value="1928">1928</option>
                                                        <option value="1927">1927</option>
                                                        <option value="1926">1926</option>
                                                        <option value="1925">1925</option>
                                                        <option value="1924">1924</option>
                                                        <option value="1923">1923</option>
                                                        <option value="1922">1922</option>
                                                        <option value="1921">1921</option>
                                                        <option value="1920">1920</option>
                                                    </select>年<select class="date_input month_input" id="id_input_val_fbecf4d4d52249a49c68da5f42f5ef53_1"
                                                        name="input_val_fbecf4d4d52249a49c68da5f42f5ef53_1">
                                                        <option value="1">1</option>
                                                        <option value="2">2</option>
                                                        <option value="3">3</option>
                                                        <option value="4">4</option>
                                                        <option value="5">5</option>
                                                        <option value="6">6</option>
                                                        <option value="7">7</option>
                                                        <option value="8">8</option>
                                                        <option value="9">9</option>
                                                        <option value="10">10</option>
                                                        <option value="11" selected="selected">11</option>
                                                        <option value="12">12</option>
                                                    </select>月<select class="date_input day_input" id="id_input_val_fbecf4d4d52249a49c68da5f42f5ef53_2"
                                                        name="input_val_fbecf4d4d52249a49c68da5f42f5ef53_2">
                                                        <option value="1">1</option>
                                                        <option value="2">2</option>
                                                        <option value="3">3</option>
                                                        <option value="4">4</option>
                                                        <option value="5">5</option>
                                                        <option value="6">6</option>
                                                        <option value="7">7</option>
                                                        <option value="8">8</option>
                                                        <option value="9">9</option>
                                                        <option value="10">10</option>
                                                        <option value="11">11</option>
                                                        <option value="12">12</option>
                                                        <option value="13">13</option>
                                                        <option value="14">14</option>
                                                        <option value="15">15</option>
                                                        <option value="16">16</option>
                                                        <option value="17">17</option>
                                                        <option value="18">18</option>
                                                        <option value="19">19</option>
                                                        <option value="20">20</option>
                                                        <option value="21">21</option>
                                                        <option value="22" selected="selected">22</option>
                                                        <option value="23">23</option>
                                                        <option value="24">24</option>
                                                        <option value="25">25</option>
                                                        <option value="26">26</option>
                                                        <option value="27">27</option>
                                                        <option value="28">28</option>
                                                        <option value="29">29</option>
                                                        <option value="30">30</option>
                                                        <option value="31">31</option>
                                                    </select>日</td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_839cc6de0b2c5704fce000ae94b1c086"><strong>选填</strong>身份证号码</div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_839cc6de0b2c5704fce000ae94b1c086"
                                        data-it="1" id="id_item_839cc6de0b2c5704fce000ae94b1c086">
                                        <div class="inputs item_form_839cc6de0b2c5704fce000ae94b1c086" id="id_item_state839cc6de0b2c5704fce000ae94b1c086">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_839cc6de0b2c5704fce000ae94b1c086"
                                                        name="input_val_839cc6de0b2c5704fce000ae94b1c086" type="text" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_9115d7d18a77aae7f2c960d49eb5e3ad"><strong>选填</strong>住址<b>(现在的居住地址)</b></div>
                                <div class="inputs"> <label class="i_item c_item" for="id_input_val_9115d7d18a77aae7f2c960d49eb5e3ad"
                                        data-it="103" id="id_item_9115d7d18a77aae7f2c960d49eb5e3ad"> <input id="id_input_val_9115d7d18a77aae7f2c960d49eb5e3ad"
                                            name="input_val_9115d7d18a77aae7f2c960d49eb5e3ad" type="hidden" />
                                        <div id="id_item_state9115d7d18a77aae7f2c960d49eb5e3ad" class="input_text"></div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_24b8791d315547a89a38b7c6f4974a88"><strong>选填</strong>具体住址<b>(具体到门牌号)</b></div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_24b8791d315547a89a38b7c6f4974a88"
                                        data-it="1" id="id_item_24b8791d315547a89a38b7c6f4974a88">
                                        <div class="inputs item_form_24b8791d315547a89a38b7c6f4974a88" id="id_item_state24b8791d315547a89a38b7c6f4974a88">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_24b8791d315547a89a38b7c6f4974a88"
                                                        name="input_val_24b8791d315547a89a38b7c6f4974a88" type="text" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_07f713db808ce94f0f84c850619f6fef"><strong>选填</strong>联系电话</div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_07f713db808ce94f0f84c850619f6fef"
                                        data-it="4" id="id_item_07f713db808ce94f0f84c850619f6fef">
                                        <div class="inputs item_form_07f713db808ce94f0f84c850619f6fef" id="id_item_state07f713db808ce94f0f84c850619f6fef">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_07f713db808ce94f0f84c850619f6fef"
                                                        name="input_val_07f713db808ce94f0f84c850619f6fef" type="number" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="sub_btn"> <a href="javascript:;" class="t-btn next" id="id_post_btn">确定</a> </div> <a href="javascript:;"
        id="id_prev_page" class="prev" data-toggle="tooltip" data-placement="top" title="返回上一题"><i class="glyphicon glyphicon-chevron-left"></i></a>
    <div class="reset">需要重新填写你的情况，请点击<a href="javascript:void(0)" id="id_restart">重填</a></div>
</div>
<div class="modal fade widget_modal" tabindex="-1" role="dialog" id="id_item_slider_2faac9d57018a6e790b1e645d6644380">
    <div class="modal-dialog modal-sm">
        <div class="modal-content">
            <div class="modal-header"> <a href="#" class="a-close" data-dismiss="modal" aria-label="Close"></a>
                <div class="ht">性别 </div>
            </div>
            <div class="modal-body">
                <div class="content">
                    <div class="options-radio widget_items"> <input id="id_input_val_2faac9d57018a6e790b1e645d6644380"
                            name="input_val_2faac9d57018a6e790b1e645d6644380" type="hidden" />
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3887">男</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3888">女</span> </div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="modal-footer"> <button type="button" class="btn btn-gray" data-dismiss="modal" aria-label="Close">返回</button>
            </div>
        </div>
    </div>
</div>
<div class="modal fade widget_modal" tabindex="-1" role="dialog" id="id_item_slider_840d01633fe8d02fbe09097db2c6aa0c">
    <div class="modal-dialog modal-sm">
        <div class="modal-content">
            <div class="modal-header"> <a href="#" class="a-close" data-dismiss="modal" aria-label="Close"></a>
                <div class="ht">民族 </div>
            </div>
            <div class="modal-body">
                <div class="content">
                    <div class="options-radio widget_items"> <input id="id_input_val_840d01633fe8d02fbe09097db2c6aa0c"
                            name="input_val_840d01633fe8d02fbe09097db2c6aa0c" type="hidden" />
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3889">汉族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3890">回族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3891">藏族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3892">苗族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3893">彝族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3894">壮族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3895">满族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3896">侗族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3897">瑶族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3898">白族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3899">傣族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3900">黎族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3901">佤族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3902">畲族 </span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3903">水族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3904">土族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3905">羌族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3906">怒族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3907">京族</span> </div>
                        </div>
                        <div class="options_row options w_item">
                            <div class="option-wrap"> <span class="option-ht" data-id="3908"> 蒙古族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3909">布衣族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3910">朝鲜族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3911">土家族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3912">哈尼族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3913">僳僳族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3914">高山族 </span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3915">拉祜族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3916">东乡族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3917">纳西族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3918">景颇族 </span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3919">仫佬族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3920">布朗族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3921">撒拉族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3922">毛南族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3927">德昂族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3928">保安族 </span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3929"> 裕固族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3932">门巴族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3933">珞巴族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3934">基诺族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3935">维吾尔族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3939">塔塔尔族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3941">俄罗斯族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3942">鄂温克族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3943">乌孜别克族</span> </div>
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                            <div class="option-wrap"> <span class="option-ht" data-id="3944">柯尔克孜族</span> </div>
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                        href="javascript:;" data-id="1678" data-is_parent="1">河南省</a><a href="javascript:;" data-id="1856"
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            <h3 class="ht" class="question-ht" data-iw="5" data-qid="b0e923c141ea0aa76a04baaf6e9c8921" id="id_question">借贷的基本法律事实填写</h3>
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                                <div class="input-ht" id="id_item_title_f4ea1ffa7ccf3cf64351e98ede03c658">你什么时候实际把钱给债务人？</div>
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                                                        <option value="1969">1969</option>
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                                                        <option value="1950">1950</option>
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                                                        <option value="1924">1924</option>
                                                        <option value="1923">1923</option>
                                                        <option value="1922">1922</option>
                                                        <option value="1921">1921</option>
                                                        <option value="1920">1920</option>
                                                    </select>年<select class="date_input month_input" id="id_input_val_f4ea1ffa7ccf3cf64351e98ede03c658_1"
                                                        name="input_val_f4ea1ffa7ccf3cf64351e98ede03c658_1">
                                                        <option value="1">1</option>
                                                        <option value="2">2</option>
                                                        <option value="3">3</option>
                                                        <option value="4">4</option>
                                                        <option value="5">5</option>
                                                        <option value="6">6</option>
                                                        <option value="7">7</option>
                                                        <option value="8">8</option>
                                                        <option value="9">9</option>
                                                        <option value="10">10</option>
                                                        <option value="11" selected="selected">11</option>
                                                        <option value="12">12</option>
                                                    </select>月<select class="date_input day_input" id="id_input_val_f4ea1ffa7ccf3cf64351e98ede03c658_2"
                                                        name="input_val_f4ea1ffa7ccf3cf64351e98ede03c658_2">
                                                        <option value="1">1</option>
                                                        <option value="2">2</option>
                                                        <option value="3">3</option>
                                                        <option value="4">4</option>
                                                        <option value="5">5</option>
                                                        <option value="6">6</option>
                                                        <option value="7">7</option>
                                                        <option value="8">8</option>
                                                        <option value="9">9</option>
                                                        <option value="10">10</option>
                                                        <option value="11">11</option>
                                                        <option value="12">12</option>
                                                        <option value="13">13</option>
                                                        <option value="14">14</option>
                                                        <option value="15">15</option>
                                                        <option value="16">16</option>
                                                        <option value="17">17</option>
                                                        <option value="18">18</option>
                                                        <option value="19">19</option>
                                                        <option value="20">20</option>
                                                        <option value="21">21</option>
                                                        <option value="22">22</option>
                                                        <option value="23">23</option>
                                                        <option value="24">24</option>
                                                        <option value="25">25</option>
                                                        <option value="26">26</option>
                                                        <option value="27">27</option>
                                                        <option value="28">28</option>
                                                        <option value="29" selected="selected">29</option>
                                                        <option value="30">30</option>
                                                        <option value="31">31</option>
                                                    </select>日</td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_dd1ef33a739f80b9e01c633843eb9a78">通过什么方式将钱给被告？<b>(如现金支付、银行汇款、支付宝转账、微信转账等)</b></div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_dd1ef33a739f80b9e01c633843eb9a78"
                                        data-it="1" id="id_item_dd1ef33a739f80b9e01c633843eb9a78">
                                        <div class="inputs item_form_dd1ef33a739f80b9e01c633843eb9a78" id="id_item_statedd1ef33a739f80b9e01c633843eb9a78">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_dd1ef33a739f80b9e01c633843eb9a78"
                                                        name="input_val_dd1ef33a739f80b9e01c633843eb9a78" type="text" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_c78841f988dbb75bc1cf4399ae01fc40">已还本金是多少？<b>(未还的就填0)</b></div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_c78841f988dbb75bc1cf4399ae01fc40"
                                        data-it="5" id="id_item_c78841f988dbb75bc1cf4399ae01fc40">
                                        <div class="inputs item_form_c78841f988dbb75bc1cf4399ae01fc40" id="id_item_statec78841f988dbb75bc1cf4399ae01fc40">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_c78841f988dbb75bc1cf4399ae01fc40"
                                                        name="input_val_c78841f988dbb75bc1cf4399ae01fc40" type="number" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                            <div class="options_row">
                                <div class="input-ht" id="id_item_title_56e362df1d9f081fcdf43dc282955b9e">已还利息是多少？<b>(未还的就填0)</b></div>
                                <div class="inputs"> <label class="i_item" for="id_input_val_56e362df1d9f081fcdf43dc282955b9e"
                                        data-it="5" id="id_item_56e362df1d9f081fcdf43dc282955b9e">
                                        <div class="inputs item_form_56e362df1d9f081fcdf43dc282955b9e" id="id_item_state56e362df1d9f081fcdf43dc282955b9e">
                                            <tr>
                                                <th></th>
                                                <td><input class="input_text" id="id_input_val_56e362df1d9f081fcdf43dc282955b9e"
                                                        name="input_val_56e362df1d9f081fcdf43dc282955b9e" type="number" /></td>
                                            </tr>
                                        </div>
                                    </label> </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
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